RT Journal Article
T1 Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing Enterobacterales in Kidney Transplant Recipients.
A1 Gutiérrez-Gutiérrez, Belén
A1 Pérez-Nadales, Elena
A1 Pérez-Galera, Salvador
A1 Fernández-Ruiz, Mario
A1 Carratalà, Jordi
A1 Oriol, Isabel
A1 Cordero, Elisa
A1 Lepe, José Antonio
A1 Tan, Ban Hock
A1 Corbella, Laura
A1 Paul, Mical
A1 Natera, Alejandra M
A1 David, Miruna D
A1 Montejo, Miguel
A1 Iyer, Ranganathan N
A1 Pierrotti, Ligia Camera
A1 Merino, Esperanza
A1 Steinke, Seema Mehta
A1 Rana, Meenakshi M
A1 Muñoz, Patricia
A1 Mularoni, Alessandra
A1 van Delden, Christian
A1 Grossi, Paolo Antonio
A1 Seminari, Elena María
A1 Gunseren, Filiz
A1 Lease, Erika D
A1 Roilides, Emmanuel
A1 Fortún, Jesús
A1 Arslan, Hande
A1 Coussement, Julien
A1 Tufan, Zeliha Koçak
A1 Pilmis, Benoit
A1 Rizzi, Marco
A1 Loeches, Belén
A1 Eriksson, Britt Marie
A1 Abdala, Edson
A1 Soldani, Fabio
A1 Lowman, Warren
A1 Clemente, Wanessa Trindade
A1 Bodro, Marta
A1 Fariñas, María Carmen
A1 Kazak, Esra
A1 Martínez-Martínez, Luis
A1 Aguado, José María
A1 Torre-Cisneros, Julián
A1 Pascual, Álvaro
A1 Rodríguez-Baño, Jesús
A1 Investigators from the REIPI/ESGICH/ESGBIS/INCREMENT-SOT Group, 
K1 BSI
K1 ESBL-E
K1 UTI
K1 bloodstream infection
K1 ertapenem
K1 extended-spectrum-β-lactamase-producing Enterobacterales
K1 kidney transplant
K1 urinary tract infection
AB There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22; P = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29; P = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.
YR 2021
FD 2021-08-09
LK https://hdl.handle.net/10668/25533
UL https://hdl.handle.net/10668/25533
LA en
DS RISalud
RD Apr 8, 2025